Lu Yi-An, Tsai Ming-Shao, Lee Li-Ang, Lee Shu-Ru, Lin Li-Yun, Chang Chain-Fen, Lin Wan-Ni, Hsin Li-Jen, Liao Chun-Ta, Li Hsueh-Yu, Wen Yu-Wen, Fang Tuan-Jen
Department of Otolaryngology Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, No. 5 Fushing St., Taoyuan 333, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Diagnostics (Basel). 2021 Feb 7;11(2):255. doi: 10.3390/diagnostics11020255.
(1) Background: Patients with laryngeal cancer usually present with dysphonia. However, some studies reported that the duration from dysphonia to cancer diagnosis has been prolonged significantly in recent years. This study aimed to evaluate that in the initial dysphonia-related diagnosis and the interval between the diagnosis of laryngeal cancer may affect the overall survival (OS). (2) Methods: The 1997-2013 Longitudinal Health Insurance Database was used in this study. A propensity score with 1-to-1 matching was applied to balance the baseline characteristics. The OS was examined by the Kaplan-Meier method and log-rank test. (3) Results: A total of 2753 patients with a first primary laryngeal cancer diagnosis were identified. The patients without prior dysphonia-related diagnosis (PD-) group did have a significantly worse five-year survival ( = 0.015) comparing with those with a prior dysphonia-related diagnosis (PD+) group among glottic cancer patients. The group with a shorter dysphonia-to-diagnosis interval had a better five-year OS than the prolonged group ( = 0.007) in laryngeal cancer. (4) Conclusions: Looking for medical assistance before a diagnosis of glottic cancer is associated with a better overall survival, while a diagnostic delay of more than 30 days from the first medical examination for dysphonia is associated with a worse outcome among in patients with laryngeal cancer.
(1) 背景:喉癌患者通常表现为声音嘶哑。然而,一些研究报告称,近年来从声音嘶哑到癌症诊断的时间间隔已显著延长。本研究旨在评估初次与声音嘶哑相关的诊断以及喉癌诊断之间的间隔时间是否会影响总生存期(OS)。(2) 方法:本研究使用了1997 - 2013年纵向健康保险数据库。采用1:1匹配的倾向评分法来平衡基线特征。通过Kaplan - Meier法和对数秩检验来检验总生存期。(3) 结果:共确定了2753例首次诊断为原发性喉癌的患者。在声门癌患者中,与有既往声音嘶哑相关诊断(PD +)组相比,无既往声音嘶哑相关诊断(PD -)组的五年生存率显著更低(P = 0.015)。在喉癌患者中,声音嘶哑至诊断间隔时间较短的组比间隔时间延长的组五年总生存期更好(P = 0.007)。(4) 结论:在诊断声门癌之前寻求医疗帮助与更好的总生存期相关,而从首次因声音嘶哑进行医学检查起诊断延迟超过30天与喉癌患者的预后较差相关。